Blood and Marrow Transplant

Blood and marrow transplantation is a special treatment procedure which may be appropriate for some cases of multiple myeloma, leukemia and lymphoma.

Nebraska Medicine stem cell transplantation program has been ranked as
one of the busiest adult and pediatric stem cell transplantation programs in the
world. The program, which was established in 1983, has been recognized internationally
for pioneering autologous transplantation using peripheral stem cells as an alternative
rescue product; conducting ground-breaking transplant studies; and performing transplants
in alternate settings other than traditional inpatient hospital units.

Nebraska Medicine is the only hospital in the country with two physicians
on the National Comprehensive Cancer Network's (NCCN) board of directors and the
only National Cancer Center (NCI) designated cancer center in this region of the
country. Patients receiving care at Nebraska Medicine receive both the
clinical expertise of our academic and private practice physicians and have access
to new procedures and technology through the work of researchers performing
blood and marrow clinical trials at the University of Nebraska Medical Center.

While the transplant procedures take place in the hospital, a patient can move to
The Lied Transplant Center for recovery and to participate in cooperative care once
they are ambulatory, or able to move around. Cooperative care is a revolutionary
approach that allows patients and their care partners to play an active role in
the treatment and recovery process following transplantation, cancer care and treatment
of other illnesses.

Care partners, usually a family member or friend, assist in all aspects of the recovery
process including administering medications, monitoring health changes, attending
informational classes and more. The cooperative care environment allows patients
and care partners to learn the skills they will need when they return home. Care
partners and patients stay in a comfortable home-like suite that includes a private
bedroom, bathroom, living room, kitchenette and two televisions.
Support groups are also available for those in need of support during and
after cancer treatment.

UNMC Physicians

Bone marrow is the spongy tissue inside the bones, which produces many cells of
the blood. In diseases involving the bone marrow, such as leukemia and aplastic anemia, normal bone marrow production has been altered.
The bone marrow produces abnormal numbers or abnormal types of blood cells. In other
diseases such as lymphoma, testicular cancer
and breast cancer, the marrow may or may
not be directly affected, but the cancer does involve other cells in the body.

The process of Hematopoietic Cell Transplantation (HCT) is a type of transfusion,
not a surgical procedure. In transplantation, the transfusion consists of collecting
special cells from the marrow or the blood, called stem cells. These stem cells
are an early form of blood cell that produces red blood cells, white blood cells,
platelets and additional stem cells. Normally in cancer treatment, the effect of
therapy on the bone marrow limits the amount of treatment that can be given. When
we give stem cells from the marrow or peripheral blood as a “rescue” transfusion,
it is possible to give higher doses of therapy. This, of course, increases the chances
of a good response to the therapy.

The stem cells used for the rescue or recovery are collected from the patient or
a donor and then given to the patient after the cancer therapy has been administered.
There are different types of transplants; each is named according to the donor of
the stem cells. Blood and marrow stem cell transplants are grouped into several
categories based on how the stem cells are collected. These include:

Bone marrow transplant is a procedure where the stem cells are collected from the
bone marrow.

Peripheral blood stem cell transplant is the procedure where the stem cells are
collected from the peripheral blood.

Allogeneic (al-lo-jen-a-ick) transplant is the term used when the transplanted bone
marrow or peripheral blood stem cells are collected from a person specifically typed
and matched with the patient. Usually this is a relative such as a brother or sister,
known as a related transplant. In some instances the donor may be an individual
from the National Marrow Donor Program; when this is the case, it is called an unrelated
transplant. If an autologous transplant is being done stem cells will be specially
prepared, preserved and then frozen. These cells will then be carefully thawed prior
to infusion during the transplant.

Autologous (aw-tall-o-gus) transplant is the term used when a patient’s own bone
marrow or peripheral blood stem cells. The patient will donate the stem cells before
radiation and chemotherapy for infusion later in the treatment process.